Study Question Aziza Sayed Omar, M.D.
In this session, we will… • Discuss guidelines for creating a ‘good’ research question • Provide time to revisit and revise your research questions and plans • Consider appropriate methods for investigating your research question(s)
What is Research? Research is the systematic process of collecting and analysing information (data) in order to increase our understanding of the phenomenon with which we are concerned or interested. Research involves three main stages: planning data collection analysis.
The Research Process • • • • • •
Originates with a question or problem. Requires a clear articulation of a goal. Follows a specific plan of procedure. Usually divides the principal problems into more manageable sub-problems (hypotheses), which guide the research. Accepts certain critical assumptions. Requires collection and interpretation of data to answer original research question.
Ways to select research topics: Personal experience. Whether you want to evaluate the effectiveness of an intervention or understand how or why it works Curiosity about something in the media. State of knowledge in the field Solving a problem. Hot topics under discussion Personal values Everyday life. Gaps in the research and theoretical literature.
Why are research questions important? “Well-crafted questions guide the systematic planning of research. Formulating your questions precisely enables you to design a study with a good chance of answering them.�
RESEARCH QUESTION A proper research question is the cornerstone of any study
Architecture of a focused question: a 4-part review question
P - Who is the patient or what problem is being addressed?
I - What is the intervention or exposure? C – What is the comparison group? O - What is the outcome or endpoint? + study design Richardson et al. The well-built clinical question: a key to evidence-based decisions. ACP Journal Club 1995;A-12 Counsell C. Formulating questions and locating primary studies for inclusion in systematic reviews. Ann Intern Med 1997;127:380-7.
1. Patient: 1. Disease or condition 2. Stage, Severity 3. Demographic characteristics (age, gender, etc.)
2. Intervention: 1. Type of intervention or exposure 2. Dose, duration, timing, route, etc.
3. Comparison: 1. Absence of risk or treatment 2. Placebo or alternative therapy
4. Outcome: 1. Risk or protective 2. Dichotomous or continuous 3. Type: mortality, morbidity, quality of life, etc.
PICO + study design Study designs: RCTs Cohort Case-control Cross-sectional All
Types of questions (domains) • • • • • •
Etiology [cohort, case-control] Therapy [RCT] Prognosis [cohort] Harm [cohort, case-control] Diagnosis [cross-sectional, case-control] Economic [cost-effectiveness analysis, etc.] These domains are usually addressed by different study designs
Formulation of a therapy question Intervention
Outcome
Is Zinc effective in treating cold? Patient/problem
Intervention
In children with common cold, is oral Zinc effective in reducing the duration of symptoms, as compared to placebo?
Outcome
+ RCTs
Comparison
Formulation of an etiology question Exposure
Outcome
Is snoring a risk factor for diabetes? Patient
Exposure
Are people who snore regularly at a greater risk of developing type II diabetes mellitus as compared to those who do not snore?
Outcome
+ cohort & case-control studies
Comparison
Formulation of a diagnosis question Test (intervention)
Outcome
Is Positron Emission Tomography (PET) a good test for coronary disease? Test (intervention)
Outcome
Patient
Is PET a more sensitive and specific test in diagnosing coronary artery disease as compared to coronary angiography? + diagnostic studies [cross-sectional]
Comparison
Remember, you will spend a lot of time researching and writing about the proposed project : { if it does not interest you in the beginning, it will certainly become very difficult to write
about in the end.}
To write a strong research question you will need time. So; 1.Step away from your computer; 2.Consider what attracted you to your topic. 3.Listen to yourself and start formulating your question by following your own interests.
4. Next, extensively research your topic. 5. What have people said about it? 6. How have they framed their research? 7. What gaps, contradictions, or concerns arise for you as you read, talk to people, and visit places? After you have done this you can go back to your computer or note pad and start crafting the question itself.
The research question should be 1
2
3
4
Evocative
Relevant
Clear
Researchable
1
The research question should be Evocative
Evocative questions are ones that catch the interest of the reviewer and draw her/him into the proposal. Also, they easily adhere in the reviewers’ memory after reading the proposal. Questions tend to be evocative because they pose innovative approaches to the exploration of problems, and because of this the answers found are far from obvious.
There is no single way to form a conceptually innovative question. However, some of the following qualities are common to successful proposals.
1
The research question should be Evocative
Make it timely Evocative questions are often extracted from very contemporary and recent social, medical or theoretical concerns. For example, questions regarding the energy crisis, international tribunals, bird flu, or the rise of antiglobalization protests are likely to attract the interests of others because they are questions whose relevance will be clearly perceptible by the senses or intellect of reviewer.
1
The research question should be Evocative
Frame it as a paradox (A self contradiction) Frame your question around a provocative paradox. For example, why the incidence of bird flu increases despite the enormous efforts to combat its spread? Or why there is an increased incidence of schistozomal infection despite the huge health education program?
1
The research question should be Evocative
Take a distinctive approach A question that approaches an old problem in a fresh new way, or proposes a surprising view of analysis on a difficult dilemma, is likely to prove evocative for reviewers. This could involve;
1. A new methodology, 2. A new conceptual approach, or 3. The linking of two previously disparate fields of knowledge.
2
The research question should be Relevant
Questions that clearly demonstrate their relevance to; 1.Society, 2.A social group, or 3.Scholarly literature and debates Are likely to be given more weight by reviewers. As a general rule, research is more likely to be funded if it is seen as part of a larger intellectual project or line of inquiry, not just a way for the researcher to get a degree.
2
The research question should be Relevant
Fill in the missing piece If your proposal can expose a given field or problem and then point to a specific portion that is missing in that field or so , a gap which will be filled by the answer to your research question, your research is likely to obtain a great deal of support and fund. Reviewers will note its importance and recognize its relevance to a larger community of researchers.
3
The research question should be Clear
Clear questions tend to be
1.Short, 2.Conceptually straightforward, and 3.Jargon-free (Blablabla). This does not mean they have to be overly simplistic; but save your efforts for the analysis.
3
The research question should be Clear
Ground the questions Keep your questions close to the topic or place you are researching. Questions that are too abstract or obtuse make it difficult for the reader to determine your question’s relevance and intent. You must still link your question to a larger context or objective
3
The research question should be Clear
Limit variables If a question is burdened with too many variables or too many clauses it becomes both difficult to read and difficult to research. For example : a question like “Was the decline of poliomyelitis in Egypt the result of government policies?” is much easier to understand than “Was the decline of poliomyelitis in Egypt related more to health education, the vaccination campaign, or people awareness?”
3
The research question should be Clear
You may talk about all these factors in your proposal, but the first question allows the reader to focus on the central aspect of your research rather than the variables surrounding it.
4
The research question should be Researchable
Research questions need to be clearly “doable.� One of the most common rationales for rejecting proposals is that the question is simply too expansive (or expensive) to be carried out by the applicant. There are many questions that you will need to ask yourself to avoid this pitfall. Above all else, consider your limitations.
4
The research question should be Researchable
First among them is: How long will the research take to carry out? Next, do you have the appropriate background to carry out the research? Are there ethical constraints? Is the project likely to be approved by your advisor and your University’s committee for the protection of human subjects? Can you obtain the cooperation from all the necessary individuals, communities and institutions you need to answer the question you have asked?
4
The research question should be Researchable
Are the costs of conducting the research more than you will be likely to raise? If I can’t complete this project well, can I break it down and address the most important component? Remember that writing a research question is a tedious, repetitive process and such concerns need to be carefully considered in your research design and budget.
CONCLUSSION When you do, consider that a strong research question should be: Evocative, Clear, and specific Reflects the objective(s) of the study It has no answer by common sense It has no answer in the literature Finding an answer to the question will solve or at least help in solving the problem to be studied
ANY QUESTIONS ?
THANK YOU
Outline of a protocol Background Problem statement and importance of the problem addressed Rationale for the review Have there been other reviews on this topic? How will your review be different from others on the same topic?
Outline of a protocol Objectives: Precise statement of the primary objective of the review, including the intervention(s) reviewed and the problem addressed. If there are hypotheses for the review (specific theories or suggestions being tested), these should be stated here.
Outline of a protocol Criteria for considering studies for this review (PICO) Types of participants Types of interventions Types of outcome measures Types of studies (study designs)
Outline of a protocol Search strategy: What databases and sources will be searched? What will be the time period? What search terms and key words will be used? Will there be language restrictions? How will conference abstracts be handled? Will unpublished data be sought? Who will run the searches?
Outline of a protocol Methods: Eligibility: What will the inclusion/exclusion criteria be? Who & how many reviewers will screen the articles for inclusion? How will the reviewers resolve disagreements? Will the articles be reviewed in a blinded manner?
Outline of a protocol Methods: Data extraction: Who and how many reviewers will extract data? What data will be extracted? How will the reviewers resolve disagreements? Will data extraction be done in a blinded manner? Will inter-rated reliability be measured?
Outline of a protocol Assessment of study quality: Who and how many reviewers will assess study quality? What instrument or scale will be used for quality assessment? Will a numeric quality score be measured? Will quality assessment be done blinded? How will the reviewers resolve disagreements? Will inter-rated reliability be measured? How will the quality data be used?
Outline of a protocol Analysis: What software will be used How heterogeneity will be evaluated If a meta-analysis will be done, what model will be used for combining data (random vs. fixed effects) If heterogeneity is found, what approaches will be used to find reasons for heterogeneity Will subgroup analyses be done Will sensitivity analyses be done How will quality of studies affect the analyses How potential publication bias will be evaluated
Exercise Individually, for each of the research questions in the handout, determine: if the question meets the 8 guidelines discussed earlier suggestions for improving the question
Share your results with a neighbor Be prepared to report to the full group